Major Causes of SSI Improper Payments

The table below indicates the major causes of improper payments (overpayments and underpayments) in FY 2014 for the SSI program using OMB’s categories of error:

Improper Payment Root Cause Category Matrix for FY 2014
(dollars in millions)

 

SSI Program

Reason for Improper Payment

Overpayments

Underpayments

Program Design or Structural Issue

$0

$0

Inability to Authenticate Eligibility

$3,518

$614

Failure to Verify:

 

 

Death Data

$5

$0

Financial Data

$63

$51

Excluded Party List

$0

$0

Prisoner Data

$0

$0

Other Eligibility Data

$127

$32

Administrative or Process Error Made by:

 

 

Federal Agency

$212

$143

State or Local Agency

$0

$0

Other Party (e.g., participating
lender, health care provider,
or any other organization
administering Federal dollars)

$0

$0

Medical Necessity

$0

$0

Insufficient Documentation to Determine

$0

$0

Other Reason (a) (explain)

$0

$0

Other Reason (b) (explain)

$0

$0

TOTAL

$3,924

$840


The following tables indicate the major causes of SSI overpayments and underpayments, for FYs 2010-2014, as determined by our payment accuracy reviews:


Major Causes of SSI Overpayments FY 2010 – FY 2014
Financial Accounts The applicant or recipient (or his or her parent or spouse) has financial accounts that exceed the allowable resource limits ($2,000 individual/$3,000 couple) that may result in periods of SSI program ineligibility.
Wages The recipient (or his or her parent or spouse) has actual wages that exceed the wage amount used to calculate payment.
In-Kind Support and Maintenance In-kind support and maintenance is unearned income received in the form of food or shelter. The error results when the recipient’s amount of in-kind support and maintenance is more than the amount used to calculate payment.
Other Real Property Undisclosed non-home real property is a growing cause of improper overpayments in the SSI program. SSI ineligibility may result if the recipient is the owner of real property other than his or her principal place of residence.


Major Causes of SSI Underpayments FY 2010 – FY 2014
In-Kind Support and Maintenance In-kind support and maintenance is unearned income received in the form of food or shelter. The error results when the recipient’s amount of in-kind support and maintenance is less than the amount used to calculate payment.
Living Arrangements We paid the recipient as if he or she was “living in the household of another” when he or she was living in his or her own household for SSI purposes and, therefore, the recipient is due a higher payment amount.
Wages The recipient (or his or her parent or spouse) has actual wages that are less than the wage amount used to calculate payment.